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Individual

ANTHONY NIOSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10898 BAYMEADOWS RD STE 300, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32256-5838
(904) 363-2733
(904) 363-3484
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME71438
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00092786
RR MEDICARE
FL
Enumeration date
02/03/2006
Last updated
12/19/2018
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